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HomeMy WebLinkAboutSWG2024-00383 - SWG As-Built - 11/1/2024 e Mason County OSS Installation.Report pg. 1 MASON COUNTY PUBLIC HEALTH APPLICANT/ PERMIT INFORMATION Permit Number SWG 2024-00383 Parcel# 22325-50-06003 Applicant Name RICHARD PERRY Subdivision (Name/Div/Block/Lot) Applicant Address 291 NORTHCREST RD City, State, Zip ALLYN, WA 98524 Installer Name SCHOENING EXCAVATION Site Address 170 N E STEELHEAD DR SOUTH Designer Name CINDY WAITE INSTALLATION CHECKLIST ❑ Full System Installation ❑Tank(s)Only Drainfield Only to Repair ❑Other System Type GRAVITY Pretreatment Type >5 ft. .fromwlls?om -n? ---- - --__ U �� Oe/A fives Oxo >50 ft.from wells? - - --- - - - -- _ (��C Z >50 ft.from surface water? - - - - - - - _ _ ____ _ - ❑ © ❑ F Cleanout between building and tank? - _9�1-3 4_ - ❑ ❑ U Tank baffles present? - _ _ _ _ _ _ _ __ __ ___ ___ __ - ❑ 0 ❑ a 24"access risers over each compartme My__ _ - ❑ ® ❑ rW Effluent filter installed?-- - -- - --- -- -- ---- ---- ---- - - ❑ ® ❑ Septic tank capacity (working) 1000 oal Manufacturer EXISTING �0 D-box water level and speed levelers used? - --- - - ❑ wq WYES xo 00 Manifold/D-box accessible from surface?__ __ _ __ _ _ _ ___ __ __UL ❑ -,1t1 d�� O o¢ Check valves installed? -__ _ _ ___ _ __ _ _ _ __ _ _ _ __ _ ___ - ❑ ❑ C��po+Iyn ❑ 2 Transport Line Size Schedule/Class Bedrooms installed (check one) E 2 ❑3 ❑4 ❑5 ❑6 ❑Commercial/Other >10ft.from foundation?---- ---------------------- ❑ N/A ® YES NO G >100 ft.from wells?-- ❑ ® _ ❑ W >100 ft.from surface water? -______________________- ❑ ❑ M >10ft.from potable water lines?--____---------------- ❑ El>5ft.from property lines and easements?- --------------- ❑ © ❑ G > 30ft.from downgradient curtainlfoundation drain?--- ---- --- ® ❑ Drainfield level and observation ports present ------- ------ . ❑ ® ❑ ❑ Graveless chambers or 0 Clean gravel used? (check one) Proper cover installed over drainfield?---- ------- -------- ❑ Q ❑ Pump tank setbacks consistent with septic tank?------------- ❑ WA ❑ YES Q No Y Pump tank capacity(flood) gal Manufacturer F24"access riser(s)and accessible from surface?------------- ❑ ❑ ❑ a Alarm or Control Panel Installed? -- --- -- --- - -- ----- --- ❑ ❑ ❑ Control Panel equipped with Timer/ETM/Counter--- ------- - ❑ ❑ ❑ n. Pump installed in ❑ Bucket or ❑ On Block or ❑ Other Pump Make/Model ❑ Floats or ❑ Transducer IL a Tank draw down in/min Pump capacity apm Squirt Height ft Pump on time Pump off time Daily flow set at opd �We1M MrY1018 Mason COU*088 Installation Report Pa. 2 parcel s 22007-50.00028 ABANDONMENT RECORD Wue exYap septic cormoonenm abandoned as pan of this projew •-- If Y",platy dae U- ❑ YES tK No YWtaaB eomponeraa p""I"d eat and P"Idy abandoned Per WACZ4t4P zs a3009 •--_--_. ❑ 166,1 nlrresesasr NraaWaiNIM RECORD DRAWING abaWrmlbla aalYllllae�tlaaalYYae Mdomp aalvyN YlAbelbbee laWp aO.ahW\�III� �e4e�aa Ya NI11CG.NNtlINfWlIMaN ��aeaYW YI YIw Capra lNNYamC erel�aalaeafaal�lYYtlo��pYlb bev7bbfbaq eaYaa4 aaaaaapNlrgalaap Malty•aaLwblNlw, awoas sso seas Ilalsal sage b aY belYa gpiapl atl�W bO PNMIa XRecord orawlnaAfacnod rthe TALLER I mateded On DESIGNER/ENGINEERByafMn M atk'G/dBnCa with I cedi&thatthe system has been fneteded In . ttd aMatpn�tnpad'APPROVED'by Meson dance wtth the aeptk dealpn atampad'APPROVER•by ty Pubaa HealtM and Mat any devledona shown Mason County Public Health and yet any deWsdalahave bean otenadfapproved by both the designer shown here have been rJeared/eppmvsd byboMMdaan County Pubdd Health and mast ell State myself end Mason County pubae l+wan and meatas M1e�Counly C0d1dState antl Meson County Codes ercartlry Mat as Inlbrmadon contained on this I further certify that so ln&MNW n IWrrr and edarhadRaootd DlaHfirp kBCOarata, contained on Mk tone end attached Record Drawleg is scoumte. 8lprrb'sc aflnitaAr Oak WWNDOW"PU JCHEALTH ' 1414 tt #*P M We fnetWIgllonwROPW and 5t 1a��LEV 1� Ream an•& r a Mnd County pubmd �LICCINDYNSE o ES] Ell ppy����y�� � C%tIN6 0910r wV�alaaalaaaalmBl � a.q �'.� (stamp,signature and data) THIS FORM MAYBE SCANNED ANDAVAILABLE FOR PUBLICVIEW ONTHB MAMN COUNTYWEsenE Wr.eabma APPROVED ' ROVED ••• 6fASON COUNTY&VIRONMENTAL HEALTlf- RETCI ► 7 s1 StOWIB �n °Y LICENSE E Es t1 '►' N1 z MdsoN o,' T 12 V4 ... .. .I �.. Jaw,MFNTA�HEtLTH ... v rn a w o Q N O & fD N 3 .7.'.O X ;V IV 7' N .N z c T• N C Q h. cD .O. t0 7 m 'O 5 7 FX 77C" !D O, fD 311 Q r ti s 2 , _............................ awl zo APPROVED NOV 01 2024 51 to 2- MASON COUNTY ENVIRONMENTAL HEALTH 6_/y2 r L RET Y7 �I �"tea a /Z" C) 7- b l reft 44, s'/�VA No Sc g 6 Q�1 I �k.AC♦ 6l�(y r..+ !'OUTS ti LICE act►T d.,i S7.+ti I OCT L• k a, MASON CODUTT ^� ,VENTAL NEALTN